Presented at the 2nd Joint European Stable Isotope User Meeting (JESIUM), Presqu'île de Giens, France, 31 August–5 September, 2008.
Special Issue Paper
Blood volume and red cell mass in children with moderate and severe malaria measured by chromium-53 dilution and gas chromatography/mass spectrometric analysis†
Article first published online: 14 JUL 2009
Copyright © 2009 John Wiley & Sons, Ltd.
Rapid Communications in Mass Spectrometry
Volume 23, Issue 16, pages 2467–2475, 30 August 2009
How to Cite
Macallan, D. C., Abaye, D. A., Dottin, S., Onanga, M., Kombila, M., Dzeing-Ella, A., Kremsner, P. G., Krishna, S. and Planche, T. (2009), Blood volume and red cell mass in children with moderate and severe malaria measured by chromium-53 dilution and gas chromatography/mass spectrometric analysis. Rapid Commun. Mass Spectrom., 23: 2467–2475. doi: 10.1002/rcm.4058
- Issue published online: 14 JUL 2009
- Article first published online: 14 JUL 2009
- Manuscript Accepted: 30 MAR 2009
- Manuscript Revised: 27 MAR 2009
- Manuscript Received: 30 JAN 2009
- Charitable Trustees of St George's Hospital
Understanding blood volume changes in children with malaria is important for managing fluid status. Traditionally, blood/red cell volume measurements have used radioactive chromium isotopes. We applied an alternative approach, using non-radioactive chromium-53 labelling and mass spectrometry to investigate red cell volume (RCV) in Gabonese children with malaria. Nineteen children with malaria participated (10 severe, 9 moderately severe; ages 15 months to 7 years). Blood labelled with 53Cr-chromate exvivo was re-injected, then sampled 30 min later. Pre- and post-injection 53Cr content were measured by gas chromatography/electron ionisation mass spectrometry of the chromium-trifluoroacetylacetone (TFA) chelate, calibrated against 50Cr standards. Blood and red cell volumes were calculated from isotopic dilution in 15 of 19 children (in four, insufficient signal mitigated analysis). In this small pilot study, there were no significant differences between moderate and severe cases. Including all subjects, the mean RCV was reduced compared with predicted values (184 vs. 269 mL; p = 0.016) but blood volume, 71 ± 33 mL/kg (normalised for weight), was close to predicted, ∼77 mL/kg, commensurate with reduced haematocrit. Blood lactate concentration correlated negatively with RCV/weight (r = −0.56, p = 0.028), consistent with anaemia. In one case, sequential samples over 42 days gave an estimated rate of 53Cr disappearance of 1.4%/day (equivalent half-life: 70 days). 53Cr-labelling of red cells may be used to estimate blood and red cell volumes and can be used as an investigative tool in situations such as childhood diseases and resource-constrained settings. Although the red cell mass is depleted in malaria, the blood volume appears relatively well preserved. Copyright © 2009 John Wiley & Sons, Ltd.